1.A 5-year retrospective study of melioidosis cases treated in a district specialist hospital
Ray Yank Tang ; Soon Hooi Lim ; Jo Ee Lam ; Nurasykin Salim ; Su-Sian Eileen Toh ; Yen Wen Chan
The Medical Journal of Malaysia 2019;74(6):472-476
INTRODUCTION: Melioidosis is caused by Burkholderia
pseudomallei, a gram-negative aerobic bacillus, found in the
soil and surface water. Treating melioidosis has been a
challenge in district hospitals due to high usage of broad
spectrum antibiotics and prolonged hospitalisation. This
study is to review the patients’ demography, clinical
presentations and microbiological data.
METHODS: A 5-year retrospective study was carried out on
patients admitted with culture positive for melioidosis from
year 2013 to 2017 in Hospital Teluk Intan, Perak.
RESULTS: There were a total of 46 confirmed cases of
melioidosis. Majority of the patients were working in the
agricultural and farming (28.6%), and factories (25.7%).
Thirty-one patients had diabetes mellitus (71.1%).
Presentations of patients with melioidosis included
pneumonia (54.3%), skin and soft tissue infection (19.6%),
deep abscesses (15.2%) and bone and joint infections (13%).
An average of 5.8 days was needed to confirm the diagnosis
of melioidosis via positive culture. However, only 39.4% of
these patients were started on ceftazidime or carbapenem
as the empirical therapy. The intensive care unit (ICU)
admission rate for melioidosis was 46% and the mortality
rate was 52%. Our microbial cultures showed good
sensitivity towards cotrimoxazole (97.1%), ceftazidime
(100%) and carbapenem (100%).
CONCLUSION: Melioidosis carries high mortality rate,
especially with lung involvement and bacteremia.
Physicians should have high clinical suspicion for
melioidosis cases to give appropriate antimelioidosis
therapy early